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m3n4.net July 16, 2018


162 doctors are among 601 suspects US charges with health care fraud

01 July 2018, 12:34 | Louis Holland

Feds charge 600 in opioid fraud that bilked $2B from government and insurers

U.S. Attorney General Jeff Sessions arrives for a news conference to announce a nation-wide health care fraud and opioid enforcement action at the Justice Department in Washington

"Health care fraud is a betrayal of vulnerable patients, and often it is theft from the taxpayer", said Attorney General Jeff Sessions.

Among those caught in the crackdown were 124 defendants in DOJ's South Florida district for false claims totaling more than $337 million.

"We've charged another 162 people, including 32 doctors, with illegal distribution of opioids - just opioids - so, this is the most doctors and the most medical personnel, unfortunately, and the most fraud that the Department of Justice has ever taken on in any single enforcement action", said the attorney general.

Among the accused are 76 doctors, 23 pharmacists and 19 nurses. The group faces charges for their alleged roles in how they prescribed addictive opioid painkillers. And the Justice Department says that while most medical professionals are honorable, this group took advantage of the opioid crisis for their own benefit.

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In part, the charges involved the fraudulent billing of private insurers and government programs such as Medicare, Medicaid and Tricare. These are despicable crimes.

"Healthcare fraud touches every corner of the United States and not only costs taxpayers money, but also can have deadly consequences", said FBI Deputy Director Bowdich. I want to thank our fabulous partners with the FBI, DEA, our Health Care Fraud task forces, HHS, the Defense Criminal Investigative Service, IRS Criminal Investigation, Medicare, and especially the more than 1,000 federal, state, local, and tribal law enforcement officers from across America who made this possible.

"It is not that we are over-regulating, but doctors and medical practitioners are more aware", he said.

Those claims were then submitted to organizations such as Medicaid and Medicare for services that were never provided. In many cases, investigators said, patient beneficiaries were paid cash kickbacks for supplying information to medical providers. The charges also involved unnecessary prescription drugs and compounded medications. Officials said Ruiz operated a false-front pharmacy where he stole and used the identities of patients and doctors to bill for prescriptions that patients never received, resulting in approximately $858,000 being paid out in fraudulent proceeds. Separately, dozens of distributors and drug manufacturers are facing charges from cities, states, counties, and Native American tribes in a consolidated case in an OH federal court that could yield an unprecedented settlement.

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The takedown is considered to be one of the largest health care fraud busts in U.S history.

Peresiper, a medical clinic business manager, was charged with conspiracy to pay health care kickbacks related to Pulmonary Solutions and Multi Care Medical NY, both in Brooklyn.

Those charged were accused of cheating federal health programs, including Medicare and Medicaid, through false billing practices.

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